Bone fragment and tissue harvesting system

ABSTRACT

A bone fragment and osteomedullary tissue harvesting system that includes a harvesting device, a collection vessel and tubing. The harvesting device includes a needle portion and a handle portion. The needle portion that has a needle bore that extends through at least part of the needle portion. The handle portion is operably attached to the needle portion. The handle portion includes a connection port and a vacuum control mechanism that are in communication with a handle bore that extends through the handle portion. The needle bore is in communication with the handle bore. The vacuum control mechanism includes a vacuum aperture that extends through a surface of the handle portion and is in communication with the handle bore. The collection vessel is capable of receiving aspirated bone fragments and tissue. The tubing operably connects the connection port and the collection vessel.

REFERENCE TO RELATED APPLICATION

This application claims priority to U.S. Provisional Applic. No.62/158,574, filed on May 8, 2015, and U.S. Provisional Applic. No.62/193,451, filed on Jul. 16, 2015, the contents of which areincorporated herein by reference.

FIELD OF THE INVENTION

The invention relates generally to harvesting of bone fragments andtissue. More particularly, the invention relates to a bone fragment andtissue harvesting system.

BACKGROUND OF THE INVENTION

Traditionally, doctors have used a large bore needle to aspirate bonefragments and/or marrow. However, orthopedic companies have developedtheir own versions of bone marrow aspirate concentrate systems for usespecifically with bone graft substitute. These disposable kits are usedfor aspirating and concentrating the stem cells found in the bone marrowonto a graft matrix to be implanted into the patient. Combined with abone graft substitute, bone marrow aspirate concentrate may providesimilar results to an autograft (Geistlich, 2011).

An example of one such prior art bone marrow aspiration needle isdisclosed in Allee et al., U.S. Pat. No. 8,343,133. This device includesa handle and a needle that extends therefrom. The needle has a centralbore that in addition to facilitating the aspiration of the bone marrowalso enables a guide wire to extend therethrough to facilitate accurateplacement of the device in bone. The handle includes a port to which asyringe is attached to cause the bone marrow to be aspirated through theneedle.

Landrigan et al., U.S. Patent Publication No. 2014/0257133, discloses abone marrow aspiration needle that is fabricated from a flexiblematerial. Landrigan indicates that the cannulated introducer needle canbe curved to approximate the natural curvature of the iliac crest.

Wawrzyniak et al., U.S. Pat. No. 8,852,119, describes a flexible bonemarrow aspiration needle having a helical groove in an outer surfacethereof. An elastomeric overcoat covers at least a portion of thegroove.

In the US, bone grafts are most commonly used in spine fusion surgeryand, more generally, in the fusion or arthrodesis of any skeletal joint.In addition, bone graft is generally used in trauma surgery for thetreatment of fresh fractures and non-unions, which are typicallyidentified as fractures within 6 months that have not healed properly.The bone graft materials typically bridge a gap between bone segmentsand may also provide a three-dimensional scaffold on which the bone cangrow.

Bone graft treatment is also typically used in conjunction with freshfractures where the bone has been shattered or where the patient is at avery high risk of developing a non-union fracture. Because manyfractures are not this severe and can be treated with alternativemethods of fixation, bone grafts are not frequently needed during freshfracture treatments.

Two areas where bone grafts are used is in conjunction with jointreconstruction and joint revision. For example, the bone graft may beused to fill a void between the bone and joint implant in a jointreconstruction surgery. Joint revision is much more likely to need abone graft because a large void may result from the removal of theoriginal implant. Joint revisions that use bone graft material thereforeusually require a relatively large quantity of the bone graft material.

There are different types of bone graft materials that may be used toassist a patient's body in bone regeneration. These bone graft materialsare typically classified as either natural or synthetic materials.

Natural bone graft materials are classified in the following groups.Autograft is bone graft material that is obtained from the sameindividual that will receive the bone graft material. Allograft is bonegraft material that is obtained from another human source, whichtypically is from cadavers. Xeongraft is bone graft material that isobtained from another species.

Bone grafts can also be categorized by their bone-forming properties asosteoconductive, osteoinductive or osteogenic. Osteoconductivity is theability of a material to provide an appropriate scaffold or matrix uponwhich new bone tissue can form. Osteoinductivity is the ability of amaterial to stimulate the patient's own system to form new bone.Osteogenic material generates new bone tissue itself. Osteoblasts, whichcan be found in bone marrow and mesenchymal cells, are the only cellsthat can create new bone.

Autograft bone has historically been the standard of care because of itsosteoconductive, osteoinductive and osteogenic properties. At the timeof surgery bone is taken from a donor site in the patient, often theiliac crest bone but others are used, and then is re-implanted back intothe patient at the surgical site.

Autograft is often not used, because obtaining the graft generallyrequires a second surgical procedure with associated risks and expenses.The autograft also typically results in significant post-operativeissues, most significantly pain. An additional type of autograft,concentrated cells from bodily fluids such as blood or bone marrow, isoften used as well.

In addition to autograft, many other types of bone graft are usedincluding processed cadaver bone, i.e., allograft, in the form ofdemineralized bone matrix and also so called “living cell” or “stemcell” allograft. Additionally, constituents know to be involved in newbone formation, such as bone morphogenic proteins, typically produced byrecombinant processing means, as used. Synthetic materials such astri-calcium phosphate, calcium sulphate, hydroxyapatite and others areused as well.

Summary of Bone Graft Characteristics by Material

Type Osteoconductive Osteoinductive Osteogenic Autograft Yes Yes YesBone morphogenic No Yes (strong) Yes proteins Demineralized Yes MinimalNo bone matrix Allogeneic stem cell Yes Unknown Yes Bone marrow aspirateYes Yes (strong) Yes Synthetics Yes No No

Bone graft substitutes also fall within the classification of bonefiller materials. Examples of bone graft substitutes include collagen,polymers such as silicone and some acrylics, hydroxyapatite, calciumsulfate and ceramics.

Bone cement (such as polymethylmethacylate) can be used as a bone voidfiller to treat bone voids or defects. For example, it can be used torepair fractured bones and vertebral bodies. The bone cement can be usedeither in procedures that involve direct injection of the bone cementinto the fractured vertebral body (i.e., vertebroplasty) or injection ofthe bone cement into the vertebral body after the height of thevertebral body is restored using a pressurized balloon (i.e.,kyphoplasty).

One of the disadvantages of using bone cement is that, once it isinjected inside the patient, the bone cement is an inorganic materialand, as such, is treated as a foreign body. As such, the bone cement maynot only negatively impact healing but can also lead to bone disease.

Additionally, the bone cement is typically stiffer than bone, which mayincrease the incidence of adjacent level fractures in the spine. Bonecement leakage may cause complications, and has been reported to occurin vertebroplasty and kyphoplasty procedures. If leakage does occur, thebone cement can cause soft tissue injury due to the high temperatures ofthe exothermic polymerization reaction. In addition, if the bone cementis forced into the vascular system, it can cause emboli.

Bone marrow and bone marrow aspirate concentrate are considered to havea significantly higher bioactivity than circulating blood orconcentrated blood known as platelet rich plasma. These features meanthat bone marrow is often viewed as being superior to platelet richplasma for use in orthopedic applications such as spinal fusion andtrauma surgery because the bone marrow contains progenitor cells andmultipotent stem cells, which assist in the formation of new bone.

Bone marrow aspirate concentrate has become increasingly popular in bonegrowth applications, particularly spinal fusion and trauma surgery,because of its osteogenic properties. Traditionally, autograft was thegold standard grafting material in these procedures due to the presenceof osteoblasts and osteogenic precursor cells, as well as itsosteoconductive and osteoinductive properties.

To avoid the risks associated with autograft procurement such as donorsite infection and morbidity, bone marrow aspirate concentrate has beenincreasingly used because it has similar properties as autograft andallows surgeons and patients to avoid autograft procurement.

One system for aspirating bone marrow is disclosed in Pellegrino et al.,U.S. Pat. No. 6,981,948. One configuration of the bone marrow aspirationsystem includes a needle that extends generally transverse from ahandle. A vacuum line is connected to the handle to cause bone marrow tobe drawn through the needle and into the handle.

Cox et al., U.S. Patent Publication No. 2007/0198043, discloses the useof a curved bone marrow aspiration needle. Cox indicates that the curvedbone marrow aspiration needle enables bone marrow to be aspirated fromdifferent areas by changing a distance that the bone marrow aspirationneedle is inserted and by rotating the bone marrow aspiration needle.

SUMMARY OF THE INVENTION

An embodiment of the invention is directed to a method of harvestingbone fragments and osteomedullary tissue. A harvesting device isprovided that includes a needle portion and a tip portion. The needleportion has a bore formed therein. The tip portion extends from an endof the needle portion. An aperture is formed in a bone. At least part ofthe needle portion is inserted through the aperture into the bone. Theharvesting device rotated to cause the bone fragments to be formed andtissue to be morselized. A vacuum is applied to a proximal end of thebore to cause the bone fragments and morselized tissue to be aspiratedfrom the bone.

Another embodiment of the invention is directed to a bone fragment andosteomedullary tissue harvesting system that includes a harvestingdevice, a collection vessel and tubing. The harvesting device includes aneedle portion and a handle portion. The needle portion has a needlebore that extends through at least part of the needle portion. Thehandle portion is operably attached to the needle portion. The handleportion includes a connection port and a vacuum control mechanism thatare in communication with a handle bore that extends through the handleportion. The needle bore is in communication with the handle bore. Thevacuum control mechanism has a vacuum aperture that extends through asurface of the handle portion and is in communication with the handlebore. The collection vessel is capable of receiving aspirated bonefragments and tissue. The tubing operably connects the connection portand the collection vessel.

Another embodiment of the invention is directed to a bone fragment andtissue osteomedullary harvesting needle that includes a needle portionand a tip portion. The needle portion has a bore formed therein. The tipportion extends from an end of the needle portion and includes a firsttip region, a second tip region and a third tip region. The first tipregion has at least one cutting surface and a recessed region proximatethe at least one cutting surface. The first tip region has an outerdiameter. The second tip region has an outer diameter that is less thanthe outer diameter of the first tip region. The recessed region is incommunication with the second tip region. The second tip region has atleast one aperture formed therein. The at least one aperture is incommunication with the bore. The third tip region has an outer diameterthat is not smaller than the outer diameter of the first tip region. Thesecond tip region is intermediate the first tip region and the third tipregion. The third tip region is proximate the main needle portion.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings are included to provide a furtherunderstanding of embodiments and are incorporated in and constitute apart of this specification. The drawings illustrate embodiments andtogether with the description serve to explain principles ofembodiments. Other embodiments and many of the intended advantages ofembodiments will be readily appreciated as they become better understoodby reference to the following detailed description. The elements of thedrawings are not necessarily to scale relative to each other. Likereference numerals designate corresponding similar parts.

FIG. 1 is a side view of a bone fragment and tissue harvesting andprocessing system according to an embodiment of the invention.

FIG. 2 is a perspective view of a needle for use in conjunction with thebone fragment and tissue harvesting and processing system of FIG. 1.

FIG. 3 is a side view of a prior art bone marrow aspiration needle.

FIG. 4 is an illustration of an aspiration area provided by the bonemarrow aspiration needle of FIG. 3.

FIG. 5 is a side view of the needle of FIG. 2.

FIG. 6 is an illustration of an aspiration area provided by the needleof FIG. 5.

FIG. 7 is a side view of the bone fragment and tissue harvesting andprocessing system according to another embodiment of the invention.

FIG. 8 is a perspective view of a handle portion of the bone fragmentand tissue harvesting device of FIG. 7.

FIG. 9 is a side view of the handle portion of FIG. 8.

FIG. 10 is a sectional view of the handle portion of FIG. 8.

FIG. 11 is a side view of an alternative embodiment of the bone fragmentand tissue harvesting device.

FIG. 12 is a first perspective view of a distal end of a needle portionof the bone fragment and tissue harvesting device.

FIG. 13 is a second perspective view of the distal end of the needleportion of FIG. 12.

FIG. 14 is a top view of an alternative configuration of the distal endof the needle portion.

FIG. 15 is a sectional view of the distal end of the needle portion ofFIG. 14.

FIG. 16 is an end view of the distal end of the needle portion of FIG.14.

FIG. 17 is a side view of an alternative configuration of the distal endof the needle portion.

FIG. 18 is a side view of an alternative configuration of the distal endof the needle portion.

FIG. 19 is a side view of an alternative configuration of the distal endof the needle portion.

FIG. 20 is a side view of an alternative configuration of the distal endof the needle portion.

FIG. 21 is a side view of a stop mechanism for the bone fragment andtissue harvesting device where the stop mechanism is in an assembledconfiguration.

FIG. 22 is a side view of the stop mechanism of FIG. 21 in anunassembled configuration.

FIG. 23 is a schematic view of bone fragment and tissue harvestingsystem according to an embodiment of the invention where the needleportion is inserted into a patient's ilium.

FIG. 24 is a radiological view showing the bone fragment and tissueharvesting device being pivoted while inserted into the patient's ilium.

DETAILED DESCRIPTION OF THE INVENTION

An embodiment of the invention is directed to a bone fragment and tissueharvesting and processing system, which is illustrated in FIG. 1. Thebone fragment and tissue harvesting and processing system 10 generallyincludes a harvesting device 12 that is operably attached to aprocessing device 14 with tubing 16.

The bone fragment and tissue harvesting and processing system 10facilitates extraction of bone fragments and tissue from a patient thatare then used in preparing a bone graft, as is described in more detailherein.

The terms bone fragments and tissue, as used herein, are intended to bebroadly construed to encompass all aspiratable components within thebone regardless of the nature of such components.

A significant advantage of the invention is that it is a containedsystem, which facilitates use of the invention in an operating room aswell as in an out-patient setting. The invention thereby enableshigh-quality bone grafts to be prepared in a cost-effect mannerproximate to when it is desired to use the bone graft.

The invention thereby provides a completely autologous process thatenables use of the patient's own tissue in preparing a bone graft. Inaddition to harvesting bone fragments, the invention enables high yieldharvesting of stem and progenitor cells as well as collection ofintramedullary bone graft in a process that is safe, fast and efficient.This tissue is used in conjunction with an osteoconductive matrix toform a bone graft.

The harvesting device 12 includes a handle portion 20 and a needleportion 22 that are operably connected to each other. In certainembodiments, the needle portion 22 is detachably connected to the handleportion 20. In other embodiments, the needle portion 22 is integrallyformed with the handle portion 20.

In certain embodiments, the needle portion 22 may have an outer diameterof about 6 millimeters. Forming the needle portion with this diameterminimizes the potential that bone fragments will become stuck whilebeing drawn through the needle portion 22 during the aspiration process.

The needle portion 22 having the preceding characteristics may have atwo-part configuration that include an inner shaft and an outer shaft.The inner shaft may be fabricated from a metallic material such asstainless steel. The metallic material thereby provides the needleportion 22 with a relatively high strength while having a relativelythin wall thickness. In certain embodiments, the wall thickness of themetallic material may be less than about 10 thousandths of an inch. Incertain embodiments, the wall thickness of the inner shaft is betweenabout 3 and 6 thousandths of an inch. In still other embodiments, thewall thickness of the inner shaft is about 4 thousandths of an inch.

Fabricating the inner shaft with a relatively thin wall thickness allowsthe inner channel to be relatively wide to facilitate a large flow rateof bone fragments and tissue therethrough while at the same time havinga relatively small outer diameter to minimize the size of the hole thatis formed in the bone to access the interior of the bone where the bonefragments are formed and the beneficial tissue is located.

The outer shaft may be fabricated from a polymeric material that ismolded over the inner shaft. The outer shaft thereby enhances strengthof the inner shaft while allowing the needle to deflect during the bonemarrow and tissue harvesting process. The combined structure of theinner shaft and the outer shaft provides the needle portion 22 withenhanced torsional strength compared to a needle fabricated only from ametallic material or a polymeric material.

Another advantage of using the polymeric outer shaft over the metallicinner shaft is that it is possible for the bore that extends through theinner shaft to have a relatively constant size over the length of theneedle portion 22. If the needle portion 22 had been fabricated onlyfrom a polymeric material, it would have been necessary for the innerdiameter to taper when moving from the proximal end to the distal end ofthe needle portion 22 to facilitate molding of the needle portion 22.

Because of the length of the needle portion 22, such tapering would haveresulted in a relatively thick wall proximate the proximal end, arelatively thin wall proximate the distal end or combination thereof.Such differences in wall thickness would have limited the flexing of theneedle portion 22 near the proximal end while providing too muchflexibility proximate the distal end. Both of these situations wouldhave limited the ability to maneuver the needle during the bone fragmentand tissue recovery process.

An outer diameter of the needle portion 22 may be wider proximate thehandle portion 20. Using such a configuration increases the strength ofthe harvesting device 12 such that there is less likelihood of theharvesting device 12 deforming during the process of forming the bonefragments, morselizing the tissue inside of the bone or when aspiratingthe bone fragments and tissue from the bone.

To provide the needle portion 22 with a desired level of sharpness, theneedle portion 22 has a tip that is fabricated from a metallic materialas the metallic material provides an enhanced sharpness as compared to atip 24 fabricated from a polymeric material. The tip 24 may be attachedto the distal end of the inner tube before the outer tube is molded overthe inner tube.

The sharpened tip 24, which is most clearly illustrated in FIG. 2, thatfacilitates accessing the interior of a bone. The sharpened tip 24 alsofacilitates forming bone fragments. The harvesting device 12 alsofacilitates morselizing tissue inside of the bone and thereby enhancesthe amount of osteomedullary tissue that can be recovered from apatient. The bone fragments and tissue are aspirated from the patientusing the harvesting device 12, which causes the aspirated tissue to becollected in the processing device 14.

Because there are a relatively large concentration of bone fragmentsthat are aspirated through the harvesting device 12, the tip 24 of theneedle portion 22 includes a plurality of relatively large apertures 26formed therein proximate the distal end thereof. Intermediate theapertures 26 is at least one sharpened surface 28. The at least onesharpened surface 28 facilitates cutting while the needle portion 22 isinserted into and removed from the bone. The at least one sharpenedsurface 28 also facilitates cutting while the needle portion 22 isaxially rotated and/or pivoted.

The processing device 14 generally includes a collection vessel 30 towhich a collection vessel cap 32 is operably attached. The collectionvessel 30 may be formed with a size based upon the volume of bonefragments and tissue that is anticipated to be aspirated from thepatient. In certain embodiments, the collection vessel 30 has a volumeof about 180 cubic centimeters.

The collection vessel 30 may have a variety of shapes using the conceptsof the invention. In certain embodiments, the collection vessel 30 has agenerally cylindrical shape. Using such a shape enables the collectionvessel cap 32 to be attached using a rotational motion.

A side of the collection vessel 30 may include at least two volumecollected markers 33, 35. In one embodiment, the volume collectedmarkers include an upper marker 33 and a lower marker 35. The uppermarker 33 and the lower marker 35 thereby provide guidance to the personusing the invention regarding whether a desired volume of tissue hasbeen collected. In other embodiments, the volume collected markers mayinclude a series of identifiers that correspond to a conventional volumemeasuring system such as milliliters.

Proximate an upper end of the collection vessel 30, an opening may beprovided. In one such embodiment, the opening is generally circular andhas a thread on a surface thereof that can be used when attaching thecollection vessel cap 32 to the collection vessel 30. In certainembodiments, the thread may be on an outer surface of the opening. Aperson of skill in the art will appreciate that a variety of othertechniques may be used to attach the collection vessel cap 32 to thecollection vessel 30.

One aspect of the attachment of the collection vessel cap 32 to thecollection vessel 30 is that a substantially air-tight seal is formedwhen the collection vessel cap 32 is attached to the collection vessel30 so that a vacuum may be used to draw the aspirated bone fragments andtissue into the collection vessel 30.

The collection vessel 30 may be fabricated from a variety of materialsusing the concepts of the invention. In one embodiment, at least aportion of the collection vessel 30 is fabricated from a transparentmaterial. Such a configuration enables a person using the bone fragmentand tissue harvesting and processing system 10 to not only view thevolume of aspirated tissue in the collection vessel 30 but also othercharacteristics of the aspirated tissue such as a color of the aspiratedtissue and/or the presence of discrete regions in the aspirated tissue.

Another criterion for the material that is used in fabricating thecollection vessel 30 is that the material be biologically compatible andfacilitate sterilization of the collection vessel 30 prior to use. Anexample of one such material that may be used to fabricate thecollection vessel 30 is polyethylene terephthalate.

The collection vessel cap 32 may have a generally cylindricalconfiguration with an inner diameter that is selected based upon anouter diameter of the collection vessel 30 proximate the threaded regionto facilitate removable attachment of the collection vessel cap 32 tothe collection vessel 30. In this regard, the collection vessel cap 32may include a thread on an inner surface thereof that is shapedgenerally complementary to the thread on the collection vessel 30.

While not illustrated, at least a portion of the outer surface of thecollection vessel cap 32 may have a shape and/or texture that enhancesthe ability to grasp the collection vessel cap 32 and turn thecollection vessel cap 32 with respect to the collection vessel 30.Because of the nature of the invention and the potential desire toremove the collection vessel cap 32, the collection vessel cap 32 istypically intended to be tightened and loosened using manual force.

The collection vessel cap 32 includes a first port 50 and a second port52 formed therein. A person of skill in the art will appreciate that atleast one of the first port 50 and the second port 52 may alternativelybe formed in the collection vessel 30.

The first port 50 includes a connector that facilitates attachment tothe tubing 16. In certain embodiments, the first port 50 enables tubing16 to be attached and detached. When the tubing 16 is attached, asubstantially gas-impervious seal is formed. The first port 50 mayinclude a standardized connector profile that enables a variety ofobjects to be attached thereto. An example of one suitable standardizedconnector is marketed under the identifier Leur Lock.

Similar to the first port 50, the second port 52 may be formed with astandardized connector profile. An example of one such connector profilethat can be used for the second port 52 is a tapered push-on connectorthat facilitates a friction connection. In such embodiments, the push-onconnector includes a plurality of ridges, which reduce the potential ofthe tubing or other object becoming detached from the second port 52.

The collection vessel cap 32 may be fabricated from a variety ofmaterials using the concepts of the invention. In one embodiment, atleast a portion of the collection vessel cap 32 is fabricated from atransparent material.

Another criterion for the material that is used in fabricating thecollection vessel cap 32 is that the material be biologically compatibleand facilitate sterilization of the collection vessel cap 32 prior touse. An example of one such material that may be used to fabricate thecollection vessel cap 32 is polyethylene terephthalate.

A filter container 48 is provided with respect to the processing device14. The filter container 48 is positioned so that before the bonefragments and tissue flow into the collection vessel 30, thesecomponents pass through the filter container 48. In certain embodiments,the filter container 48 is attached to an inner surface of thecollection vessel cap 32. The filter container 48 may be removablyattached to the collection vessel cap 32 such as using a threadedmechanism.

In other embodiments, the filter container 48 may be attached to anouter surface of the collection vessel cap 32. In such an embodiment,the first port 50 may be directly attached to the filter container 48.In still other embodiments, the filter container 48 may be separate fromthe processing device 14. In this configuration, the tubing 16 isattached to the filter container 48. Another section of tubing (notshown) attached the filter container outlet to the first port 50.

The filter container 48 may have a volume that is significantly smallerthan the volume of the processing device 14. In certain embodiments, thefilter container 48 has a volume of less than about 20 cubiccentimeters. In other embodiments, the filter container 48 has a volumeof about 15 cubic centimeters.

A surface of the filter container may have perforations formed therein.In certain embodiments, a lower surface 49 of the filter container 48may be perforated having a plurality of openings formed therein. Thesize of the openings may be selected to retain substantially all of thebone fragments in the filter container 48 as the bone fragments andtissue are aspirated from the patient. On the other hand, the openingsare sufficiently large so that the liquid in the aspirated is permittedto flow through the lower surface 49 and into the collection vessel 30.The perforations thereby affect physical separation of the aspirate.

In certain embodiments, the lower surface 49 is integrally formed withthe other components of the filter container 48. In other embodiments,the lower surface 49 may be removably attached to the filter container48 such as using a threaded mechanism. This threaded mechanism may besimilar to the threaded mechanism that is used to attach the filtercontainer 48 to the collection vessel cap 32.

A filter material at least partially fills the filter container 48. Thefilter material is selected with a pore size such that substantially allof the bone fragments are retained in the filter material. The filtermaterial may also be selected to retain at least a portion of thebeneficial cells in the tissue. In certain embodiments, the filtermaterial retains substantially all of progenitor cells in the extractedtissue.

The filter material may thereby provide physical separation of the bonefragments from the remainder of the material in the aspirate. Such aseparation mechanism is referred to as physical separation. The filtermaterial may also have an affinity for the beneficial components in theaspirate such that as the beneficial components flow past the filtermaterial, the beneficial components are attached to the filter materialso that the beneficial components retained in the filter container 48would be included in the bone graft fabricated therefrom.

As an alternative to providing a relatively homogeneous filter materialin the filter container 48, it is possible for the filter material toinclude more than one region. For example, there may be a top filtermaterial portion and a bottom filter material portion. The top filtermaterial portion may have a predisposition for retaining the bonefragments therein. The bottom filter material portion may have apredisposition for retaining the beneficial portions of the tissuetherein.

In addition to or as an alternate to the filter material describedabove, the filter container 48 may have a filter membrane that isfabricated with a pore size that retains a desired portion of the bonefragments and the tissue within the filter container 48. For example,forming the filter membrane with a pore size of between about 20 micronsand about 100 microns would facilitate retaining the bone fragments anda substantial portion of the progenitor cells in the filter container48.

In yet another configuration, the filter container 48 is selected toretain the bone fragments therein but substantially all of the remainderof the tissue flows into the collection vessel 30. The tissue in thecollection vessel 30 may thereby include in addition to progenitorcells, red blood cells and other components that are not needed orpotentially detrimental to forming the bone void filler. In such asituation, the red blood cells may be caused to separate from theremainder of the tissue such as mixing a material that causes the redblood cells to agglomerate and settle to the bottom of the collectionvessel 30. More details on such a process are described later in thisapplication.

Because of the challenges in aspirating the tissue that is collected inthe collection vessel 30, it is desirable for substantially all of thetissue to be retained in the collection vessel 30 for furtherprocessing. To reduce the potential of loss of the aspirated tissue thatis collected in the bone fragment and tissue harvesting and processingsystem 10, a hydrophilic membrane valve (not shown) may be attached tothe first port 52 intermediate the processing device 14 and the vacuumsource.

The hydrophilic membrane valve allows the vacuum to pull gastherethrough until the hydrophilic membrane becomes wet such as when thebone fragment and tissue harvesting and processing system 10 is knockedover or the bone fragment and tissue harvesting and processing system 10is overfilled with liquid. The hydrophilic membrane valve therebyprevents the aspirated tissue from being drawn out of the bone fragmentand tissue harvesting and processing system 10.

To minimize the potential of the processing device 14 being moved from avertical orientation, the processing device 14 may be placed in a base(not shown) having a width that is greater than the width of theprocessing device 14. An example of one suitable technique that may beused to retain the processing device 14 in a vertical orientation isdescribed herein.

An alternative or additional technique to minimize the potential ofaspirated tissue being drawn into the vacuum line may include attachingthe processing device 14 to an object proximate to the patient fromwhich the tissue is being aspirated. An example of one suitable optionis a clip that attaches the processing device 14 to an IV pole, a drapenear the patient or the operating table.

Prior to use, the components of the bone fragment and tissue harvestingand processing system 10 may be sterilized. A person of skill in the artwill appreciate that a variety of sterilization techniques may be used.An example of one suitable sterilization technique is exposure of thepackaged components to gamma radiation.

As an initial step in harvesting the bone fragments and tissue, thecollection vessel cap 32 is attached to the collection vessel 30 so thatthe bone fragment and tissue harvesting and processing system 10 lookssubstantially as illustrated in FIG. 1. The tissue harvesting device 12is attached to the processing device 14 using the tubing 16. A vacuumsource is attached to the second port 52.

A site is selected from which the bone fragments and tissue are to beharvested. It is possible to use the invention in conjunction withharvesting bone fragments and tissue from a variety of bones in apatient. Preferred sites for harvesting the bone fragments and tissueinclude the iliac crest and pedicle/vertebral bodies.

The needle portion 22 is inserted into the bone. As the tip 24 contactshard material within the bone, the tip 24 causes bone fragments to beformed. The needle portion 22 may also be rotated to cause bonefragments to be formed. In certain embodiments, the needle portion 22 isinserted while the needle portion 22 is rotated and while a vacuum isapplied to the tissue harvesting device 12. Alternatively, the needleportion 22 may be inserted a desired distance into the bone, rotated andthen a vacuum applied in sequence.

During the process of extracting the bone fragments and tissue, theneedle portion 22 may be partially withdrawn, pivoted and inserted in adifferent direction. Such a process increases the amount of bonefragments and osteomedullary tissue that is harvested from the patient.Using such a process it is desirable for the needle to flex but at thesame time not break or remain in a deformed/deflected configuration.

During the aspiration process it is important for the relatively liquidymorselized tissue to be aspirated along with the bone fragments. Such aprocess minimizes the potential of the bone fragments becoming stuckwhile passing through the harvesting device 12 and the tubing 16 beforereaching the collection vessel.

The aspiration process thereby depends on the formation of relativelysmall bone fragments, which is primarily caused by contact between theneedle tip 24 and the harder areas inside the bone. The movement of theneedle tip 24 through the interior of the bone also morselizes thetissue inside the bone and such morselizing causes the tissues to becomemore liquidy.

To enhance the volume of bone fragments and tissue that can beaspirated, the needle portion 22 may be pivoted as the distal end of theneedle portion 22 moves through the interior of the bone. Such movementcauses bone fragments to be formed. The movement also morselizes thetissue inside of the bone, which enhances the ability to withdraw thetissue. This process significantly increases the volume of beneficialbone fragments and tissue that can be harvested as compared toconventional processing techniques that merely insert the aspirationneedle into the bone at different depths. The needle portion 22 can alsobe rotated to increase the formation of bone fragments and themorselizing of tissue.

A vacuum is applied to the system, which causes the bone fragments andtissue to be aspirated through the needle portion 22. The aspirated bonefragments and tissue flow through the tubing 16 and into the processingdevice 14. This process is continued until a desired volume of bonefragments and tissue have been aspirated from the patient.

Thereafter, the bone fragments and tissue pass through the filtermaterial in the filter container 48, which retains the bone fragmentsand at least a portion of the beneficial portions of the tissue therein.Depending on the intended use of the bone void filler, it may bepossible to directly use the material in the filter container 48.Alternatively, it is possible to mix additional components to fabricatethe bone void filler.

If it is not possible to obtain a desired volume of the bone fragmentsand tissue from a particular location, it may be necessary to insert theneedle portion 22 into a different location in the bone. It may also benecessary to insert the needle portion 22 into a different bone.

It may be desirable to control the intensity of the vacuum that ispulled through the harvesting device 12. An example of one mechanism tocontrol the vacuum level is using a valve that is operably attached tothe vacuum line that is attached to the second port 52.

Conventional techniques for aspirating bone marrow that utilize arelating small diameter needle having an outer diameter of not more than5 millimeters that includes several apertures proximate a distal endthereof. Even when this bone marrow aspiration needle is rotated and/orwithdrawn during the aspiration, the relatively solid nature of thetissue inside the bone limits the amount of bone marrow that can beaspirated from a particular location.

Another drawback of the bone marrow aspiration needle is that as thisbone marrow aspiration needle is extended through tissue, it causescompaction of tissue that is displaced by the bone marrow aspirationneedle. This compaction makes it more challenging to withdraw the bonemarrow that is proximate the openings near the distal end of this bonemarrow aspiration needle.

Conventional techniques for obtaining material for use in preparingautograft utilize a coring device having an outer diameter of betweenabout 10 and 18 millimeters. This coring device is inserted into a bonea desired distance and then withdrawn to retrieve the bone matrix.

While there are some beneficial cells associated with the bone matrixthat is harvested from the patient, the volume of beneficial cells thatare harvested from the patient is considerably smaller than the volumeof beneficial cells that are harvested using the harvesting devicedescribed herein.

Nerves are primarily located on the surface of the bone. The process ofcutting through the surface of the bone disturbs the nerves and therebyleads to the patient experiencing pain. Because of the diameter of thecoring device, the patient typically experiences significant pain in theautograft harvesting region and such pain limits the use of thisprocedure.

The harvesting device 12 described herein has an outer diameter of about6 millimeters, which is significantly smaller than the coring device andthis smaller size hole that extends through the bone surface representsa reduction of the hole of between about 60 and 90 percent when comparedto the coring device.

The smaller hole associated with the harvesting device 12 describedherein thereby results in significantly lower pain than the coringdevice described above and such significantly lower pain makes the bonefragment and tissue harvesting procedure described herein to be muchmore tolerable to patients.

Another benefit of the process described herein is that using a singlehole formed in the outer surface of the bone, the bone fragment andtissue harvesting needle 22 can be pivoted and then inserted into thebone in a different angular orientation to facilitate retrieving bonefragments and tissue from different locations of the bone.

Another advantage of the harvesting device 12 described herein is thatthe cutting features on the tip cause tissue to be disturbed from alarger area and when this disturbed area is exposed to a negativepressure provided by the vacuum, such a process enables aspiratingtissue from a much larger region than is possible using the conventionalbone marrow aspiration needle.

Red blood cells have a particle size of about 7 micrometers. White bloodcells have a particle size of between about 15 and 18 micrometers. Thebeneficial osteomedullary and progenitor cells in the bone marrowaspirate have a particle size of between about 35 and 50 micrometers.

As a result of this situation is that the osteomedullary cells have asize that is considerably larger than the other components in the bonemarrow aspirate, this size difference can be used to facilitateretention of the osteomedullary cells in the filter container while themuch smaller red blood cells and white blood cells pass through thefilter container.

In addition to utilizing the affinity of the osteomedullary tissue tothe bone fragments and the size of the osteomedullary tissue tofacilitate separation, it is also possible to process the material thatcollections in the collection vessel 30 to separate the red blood cellstherefrom and then use the red blood cell depleted tissue in forming thebone graft. The process and device described herein thereby facilitatesrecovering substantially all of the beneficial cells from the tissuethat is aspirated from the patient.

The system described herein thereby results in the aspiration of asignificant amount of bone matrix. This system also results in multiplemechanisms for recovering beneficial cells from within the bone. Thefirst mechanism encompasses the beneficial cells that are associatedwith the bone fragments. The second mechanism relates to the selectiveretention of the beneficial cells as the aspirate is passed through thefilter container. The third mechanism is from the material that collectsin the collection vessel and from which the red blood cells areseparated as described in more detail herein.

The combined result of using these three mechanisms enablessubstantially all of the beneficial cells in the aspirated tissue isrecovered. Such recovery represents a significant enhancement whencompared to the prior techniques, which in addition to utilizing aninefficient harvesting process, recovered a much smaller percentage ofthe beneficial cells from the harvested tissue.

FIGS. 3 and 5 compare the structure of the prior art bone marrowaspiration needle and the bone fragment and tissue harvesting needle ofthis invention. The shaft of the prior art bone marrow aspiration needle222 is substantially straight as illustrated in FIG. 3. This traditionalbone marrow aspiration needle 222 has an outer diameter of about 4.15millimeters. Proximate the tip of the prior art bone marrow aspirationneedle 222, five openings 226 are provided. The openings 226 each have adiameter that is approximately 2 millimeters.

Three of the openings 226 a are in an aligned configuration on a frontside of the bone marrow aspiration needle 222 and two of the openings226 b are in an aligned configuration on a back side of the bone marrowaspiration needle such that the openings 226 b on the back side arebetween the openings 226 a on the front side.

Because of the generally non-liquid nature of the tissue within the bonefrom which it is desired to aspirate the bone marrow, there is a limitedability for the bone marrow to flow to the openings 226 in response to avacuum being pulled through the bone marrow aspiration needle 222 duringthe bone marrow aspiration process. In particular, if the bone marrowaspiration needle is not rotated, the area from which the bone marrowcan be aspirated is approximately the same as the size of the openings226.

To increase the amount of tissue that is subjected to the vacuum duringthe aspiration process, the aspiration needle 222 is rotated. Theincreased aspiration area associated with the rotation of the bonemarrow aspiration needle 222 is illustrated by the shaded areas 228 inFIG. 4. These shaded areas have a length of about 13.0 millimeters,which is equivalent to the circumference of the bone marrow aspirationneedle 222. The total aspiration area provided by the prior art bonemarrow aspiration needle 222 is thereby about 130 square millimeters.

While the calculations above are based upon the bone marrow aspirationneedle 222 being rotated 360 degrees so that each of the openings 226trace a path around the entire outer surface of the bone marrowaspiration needle 222, such results are not likely to be seen during theactual use of the bone marrow aspiration needle 222.

The prior art bone marrow aspiration needle 222 would be used inconjunction with a handle such as illustrated in FIG. 1. This handleenables the person performing the bone marrow aspiration to manipulatethe bone marrow aspiration needle 222. When grasping the handle, theperson's wrist would turn no more than about 180 degrees (and typicallyabout 120 degrees).

The only way for the person to rotate the bone marrow aspiration needle360 degrees is for the person to release and regrip the handle. Becauseof the cumbersome nature of the release and regrip process, the personusing the bone marrow aspiration needle is unlikely to perform thisprocess.

As described in more detail in this application, the bone fragment andtissue harvesting needle 22 has an outer diameter of about 6.3millimeters. The distal end of the bone fragment and tissue harvestingneedle 22 includes a first tip region 36, a second tip region 37 and athird tip region 38, which are illustrated in FIG. 5.

The first tip region 36 includes sharpened surfaces, which facilitatescutting tissue and forming bone fragments. The first tip region 36includes at least one of a channel and an opening to facilitateaspirating the bone fragments and morselized tissue and/or directing thebone fragments and morselized tissue to the second tip region 37.

The second tip region 38 has an outer diameter that is less than theouter diameter of the first tip region 36 to facilitate flow of the bonefragments and morselized tissue to the opening 72. A combined length ofthe first tip region 36 and the second tip region 37 is about 17millimeters.

The third tip region 38 has an outer diameter that is greater than theouter diameter of the second tip region 37 and is approximately the sameas the outer diameter of the first tip region 36. This configurationcauses the third tip region 38 to form a seal with respect to the tissuethat that is adjacent to the outer surface of the third tip region 38 sothat when a vacuum is pulled through the bone fragment and tissueharvesting needle 22, there is no leakage along the third tip region 38.

Using this configuration provides an aspiration area 39 of about 337square millimeters, as illustrated in FIG. 6. While the bone fragmentand tissue harvesting needle 22 is rotated to cause the formation ofbone fragments and morselization of tissue, such rotation is not neededto provide this aspiration area in contrast to the traditional bonemarrow aspiration needle that is discussed above with respect to FIGS. 3and 4. This aspiration area is more than 2.5 times greater than theaspiration area provided by the prior art bone marrow harvesting needle.

Another embodiment of the invention is directed to a bone fragment andtissue harvesting device as illustrated at 12 in FIG. 7. The bonefragment and tissue harvesting device 12 may be used in conjunction witha bone fragment and tissue collection and processing device 14 andtubing 16.

As described in more detail below, the bone fragment and tissueharvesting device 12 is connected to the bone fragment and tissuecollection and processing device 14 using the tubing 16. The outlet port52 on the bone fragment and tissue collection and processing device 14is connected to a vacuum source (not shown).

The bone fragment and tissue harvesting device 12 is used for accessingan interior region of a bone, forming bone fragments, morselizing tissuewithin the bone and then aspirating the bone fragments and tissue fromthe bone. The bone fragment and tissue harvesting device 12 generallyincludes a handle portion 20 to which a needle portion 22 is operablyattached.

In certain embodiments, the handle portion 20 is oriented generallyperpendicular to the needle portion 22, as illustrated in FIGS. 7-10.This configuration enables the bone fragment and tissue harvestingdevice 12 to be readily inserted into the bone and then manipulated toform bone fragments and morselize the tissue within the bone. Thisconfiguration may also facilitate tapping the handle portion 20 such aswith a mallet to urge the needle portion 22 into the bone.

The handle portion 20 may be formed with an ergonomic shape thatgenerally conforms to the shape of the user's hand when wrapped aroundthe handle portion 20. In certain embodiments, the handle portion 20 maybe formed with a generally cylindrical elongated shape having a lengththat is approximately equal to or slightly larger than a width of auser's hand. At least one of the side, top and bottom surfaces of thehandle portion 20 may be curved to generally conform to the curvature ofthe user's hand when wrapped around the handle portion 20. Using such aconfiguration facilitates a person who is using the bone fragment andtissue harvesting device 12 to wrap his/her hand around the handleportion 20 and firmly grip the handle portion 20.

The lower surface of the handle portion 20 may include at least onedepression 40 that is recessed as compared to adjacent areas of thelower surface. The depressions 40 may each be shaped to generallyconform to a portion of the shape of one of the user's fingers when theuser's hand is wrapped around the handle portion 20. In certainembodiments the handle portion 20 includes two depressions 40 that areon opposite sides of where the needle portion 22 engages the handleportion 20.

The handle portion 20 includes a vacuum connection port 42, whichenables the bone fragment and tissue harvesting device 12 to be operablyattached to the tubing 16. In certain embodiments, the vacuum connectionport 42 is located proximate a proximal end of the handle portion 20.

The vacuum connection port 42 may facilitate readily attaching anddetaching the tubing 16. A person of skill in the art will appreciatethat a variety of configurations may be used to releasably attach thetubing 16 to the bone fragment and tissue harvesting device 12.

In certain embodiments, the vacuum connection port 42 has a generallycylindrical shape. An outer diameter of the vacuum connection port 42may be slightly larger than an inner diameter of the tubing 16 so that afriction fit causes the tubing 16 to stay in engagement with the vacuumconnection port 42.

The vacuum connection port 42 may be tapered so that a diameter of thevacuum connection port 42 is greater proximate where the vacuumconnection port 42 extends from the handle portion 20, as illustrated inFIG. 9. The vacuum connection port 42 may also include at least oneridge on an outer surface thereof to enhance the ability of the tubing16 to remain engaged with the vacuum connection port 42.

The handle portion 20 also includes a suction control mechanism 44,which controls when a vacuum is drawn through the needle portion 22.When the suction control mechanism 44 is open, the vacuum pulls airthrough the suction control mechanism 44 as the resistance to flow isconsiderably lower than through the needle portion 22. When the suctioncontrol mechanism 44 is closed, the vacuum causes tissue to be drawnthrough the needle portion 22 for aspirating the bone fragments andtissue.

In certain embodiments, the suction control mechanism 44 is locatedproximate a distal end of the handle portion 20. The suction controlmechanism 44 includes an aperture 46 that extends through a surface ofthe handle portion 20 and is in communication with a handle bore 48 thatextends to the proximal end of the handle portion 20 and intersects thevacuum connection port 42, as illustrated in FIG. 8.

One technique for moving the suction control mechanism 44 to the closedconfiguration is for the person using the bone fragment and tissueharvesting device 12 to place his/her finger over the aperture 46 sothat the aperture 46 is substantially covered. In this regard, theaperture 46 should have a shape and size that are sufficiently smallsuch that the aperture 46 can be covered by the person's finger.

While the aperture 46 is illustrated as being circular, a person ofskill in the art will appreciate that aperture 46 can have a variety ofshapes using the concepts of the invention. In other embodiments, thesuction control mechanism 44 may include a mechanical valve that ismoved between open and closed positions such as by turning or sliding acomponent of the mechanical valve.

The suction control mechanism 44 may be recessed as compared to theadjacent surface of the handle portion 20 to enhance the ability of aperson using the bone fragment and tissue harvesting device 12 toaccurately place his/her finger over the aperture 46 without the personusing the bone fragment and tissue harvesting device 12 having tovisually confirm the accurate placement of the user's finger over theaperture 46. The shape of the recess may be generally circular or oval.

The handle portion 20 also includes a needle portion connection port 58that enables the needle portion 22 to engage the handle portion 20. Incertain embodiments, the needle portion connection port 58 is located onthe lower surface of the handle portion 20 approximately intermediatethe distal and proximal ends thereof.

The needle portion connection port 58 should enable a substantiallyair-tight seal to be formed between the handle portion 20 and the needleportion 22. The needle portion connection port 58 should also provide asubstantially rigid connection to be formed between the handle portion20 and the needle portion 22 such that the handle portion 20 can be usedto cause the needle portion 22 to extend through the outer surface ofthe bone and to enable the bone fragment and tissue harvesting device 12to be manipulated when forming bone fragments and morselizing tissuewithin the bone.

In certain embodiments, the needle portion 22 is removably attached tothe handle portion 20. Using this configuration enables needle portions22 having a variety of different lengths, diameters and/or cuttingfeatures to be used in conjunction with the bone fragment and tissueharvesting device 12. An example of one such technique for removablyattaching the needle portion 22 to the handle portion 20 is a threadedconnection on the adjoining surfaces of the needle portion 22 and thehandle portion 20.

The needle portion connection port 58 has a bore 59 extendingtherethrough that intersects the handle bore 48. The bore 59 may extendthrough a surface of the handle portion 20 that is generally oppositethe surface from which the needle portion 22 engages the handle portion20. In certain embodiments, the bore 59 extends through the uppersurface of the handle portion 20.

The bore 59 thereby enables a guide wire 54 to extend through both thehandle portion 20 and the needle portion 22. The guide wire 54 may beuseful in accurately forming the hole in the bone as well as orientingthe bone fragment and tissue harvesting device 12 in a direction tofacilitate optimal harvesting of the bone fragment and tissue using animaging technique such as a fluoroscope.

While it is described that the opening used for the guide wire 54 isdifferent than the aperture for the suction control mechanism 44, aperson of skill in the art will appreciate that the location of thesuction control mechanism 44 may be moved to the same location as thehole through which the guide wire 54 is extended.

A gasket 66 may be placed over the bore 59 to substantially restrict theflow of air through the bore 59. The gasket 66 may be fabricated from amaterial through which it is possible for the guide wire 54 to extend.The gasket 66 may be fabricated from a self-healing material such thatafter the guide wire 54 is removed from the gasket 66, the gasket 66 issubstantially air-tight. An example of one such material that may beused to fabricate the gasket 66 is silicone. An opening (not shown) maybe formed in the gasket 66. In certain embodiments, the opening has an Xshape and is formed using a laser.

A cover 67 may be placed over the gasket 66 to retain the gasket 66 in adesired position with respect to the handle portion 20. The cover 67 hasan aperture 64 formed near the center thereof to thereby direct theguide wire 54 to extend through the center of the gasket 66 where theopening is formed.

At least a portion of the gasket 66 and the gasket cover 67 may berecessed in the handle portion 20. Using such a configuration may enablethe upper surface of the handle portion 20 to be substantially smooth asillustrated in FIGS. 7-10.

In certain embodiments, the outer surface of the handle portion 20 mayhave a plurality of recesses 56 formed therein. The recesses 56 reducethe amount of material that is needed to fabricate the handle portion 20and such a reduction of material reduces the weight of the aspirationdevice.

Another potential advantage of the recesses 56 is that the recesses mayenhance the ability of the person using the bone fragment and tissueharvesting device 12 to grasp the handle portion 20, as any tissue andfluid that is on the user's hand may move into the recesses 56.

The handle portion 20 may be fabricated from a variety of materials thatare suitable for use in medical applications. An example of one suchmaterial that can be used to fabricate the handle portion 20 is abiocompatible polymer, which is suitable for being molded and thensterilized prior to use.

An alternative configuration of the bone fragment and tissue harvestingdevice 12 is illustrated in FIG. 11. This embodiment includes the needleportion 22 oriented at a non-perpendicular angle with respect to thehandle portion 20. In certain embodiments, an angle between the needleportion 22 and the handle portion 20 is between about 60 degrees andabout 90 degrees. In other embodiments, the angle between the needleportion 22 and the handle portion 20 is between about 65 degrees andabout 75 degrees.

Similar to the embodiment illustrated in FIGS. 7-10, the handle portion20 has a vacuum connection port 42 at a proximal end, a suction controlmechanism 44 at a distal end and a needle portion connection port 58 ina lower surface intermediate the proximal and distal ends. However, FIG.11 illustrates that the vacuum connection port 42 is a different stylethan the vacuum connection port 42 illustrated in FIGS. 7-10. This styleof connector is typically referred to as a Luer lock.

The needle portion 22 may be fabricated from a variety of materialsusing the concepts of the invention. In one such embodiment, the needleportion 22 is fabricated from a relatively rigid material so that theneedle portion 22 resists bending and/or deformation during use. Anexample of one such relatively rigid material that resists bendingand/or deformation is stainless steel.

In other embodiments, at least part of the needle portion 22 may befabricated from a material that allows the needle portion 22 to flex orbend. Using such a configuration enables the needle portion 22 to bendsuch as when the distal end of the needle portion 22 contacts a rigidportion of the bone.

The needle portion 22 should have sufficient rigidity so that the needleportion 22 moves along a particular path until the needle portion 22contacts an obstacle so that it is possible to insert the needle portion22 into the bone in different angular orientations to increase thevolume of advantageous cells that are aspirated. The needle portion 22should also be sufficiently rigid so that contact between the tip of theneedle portion 22 and bone causes bone fragments to be formed. However,the needle portion 22 should not be too rigid such that the does notdeflect when contacting an obstacle such as the opposite side of thebone.

The flexibility of the needle portion 22 may be defined in view of theability of the needle portion 22 to deflect to generally conform to acurved surface. In certain embodiments, the needle portion 22 isdeflectable using manual pressure to generally conform to a curvedsurface having a radius of less than about 20 centimeters. In otherembodiments, the needle portion 22 is deflectable using manual pressureto generally conform to a curved surface having a radius of betweenabout 10 centimeters and about 15 centimeters.

In this configuration, the needle portion 22 may be fabricated from apolymeric material such as by molding. Examples of materials that may beused to fabricate the needle portion 22 include PEEK and IXEF.

When the needle portion 22 is fabricated from a material that allows theneedle portion 22 to bend or flex, selected parts of the needle portion22 may be more rigid. For example, the part of the needle portion 22that engages the handle portion 20 may be more rigid such as when athreaded connection is used to attach the needle portion 22 to thehandle portion 20. Additionally, to facilitate forming bone fragmentsand morselizing tissue within the bone, the cutting features on theneedle portion 22 may be more rigid.

One technique that may be used to make parts of the needle portion 22more rigid is by making the wall thickness greater. Since it is desiredthat the outer dimensions of the needle portion 22 to be relativelyconstant in the part of the needle portion 22 that extend into the bone,the wall thickness may be increased by reducing the diameter of theaperture 74 that extends through the needle portion 22. The part of theneedle portion 22 that does not extend into the bone may be strengthenedby increasing the wall thickness by increasing the outer diameter of theneedle portion 22.

Another technique that may be used to increase the rigidity of selectedparts of the needle portion 22 is to add a reinforcing material and/orusing a different material to fabricate selected parts of the needleportion 22.

In view of the flexing nature of the needle portion 22, it may bedesirable to evaluate the location of the distal end of the needleportion 22 during the bone fragment and tissue harvesting process. Forembodiments where the needle portion 22 is fabricated from anon-metallic material, it may be desirable for at least part of theneedle portion 22 to be fabricated from a radiolucent material.Alternatively or additionally, a radiopaque marker may be incorporatedinto the needle portion 22. Using these techniques enables the positionof the needle portion 22 in the bone to be evaluated using an imagingtechnique such as with a fluoroscope.

The needle portion 22 should have sufficient rigidity so that the needleportion 22 provides feedback to the person using the bone fragment andtissue harvesting device 12 when the needle portion 22 contactssomething prior to deflecting in response to such contact.

The needle portion 22 has an elongated configuration with a handleattachment mechanism proximate a proximal end thereof and a tip section68 proximate a distal end thereof. As described earlier, the needleportion 22 may be removably attached to the handle portion 20 using athreaded mechanism. The handle attachment mechanism thereby facilitatesa robust connection between the needle portion 22 and the handle portion20.

Intermediate the handle attachment mechanism and a tip section 68 is amain section 70. The main section 70 is formed with a length that issufficiently long so that the handle portion 20 can be manipulatedduring the bone fragment and tissue aspiration process without thehandle portion 20 contacting the patient's body as such contact couldinterfere with the bone fragment and tissue aspiration process andpotentially lead to damage of the bone fragment and tissue harvestingdevice 12. In certain embodiments, the main section 70 has a length ofbetween about 10 centimeters and about 25 centimeters.

The main section 70 may be fabricated with sufficient strength tofacilitate urging the tip section 68 into the outer surface of the boneas well as to enable pivoting of the needle portion 22 during theprocess of aspirating the tissue while avoiding bending or breakage ofthe needle portion 22. An outer surface of at least a portion of themain section 70 may be generally cylindrical and be substantiallysmooth.

The tip section 68 may have a relatively small length as compared to theoverall length of the needle portion 22. In certain embodiments, thelength of the tip section 68 is less than about 50 millimeters. In otherembodiments, the length of the tip section 68 is about 10 millimeters.

The tip section 68 has at least one aperture 72 formed therein throughwhich the bone fragments and tissue can be drawn into a central bore 74that extends to the proximal end of the needle portion 22. In certainembodiments, there are a plurality of apertures 72 oriented in aspaced-apart configuration on the tip section 68.

The apertures 72 may be formed with different sizes. In certainembodiments, the size of the apertures 72 increases when moving towardsthe distal end of the tip section 68. Using such a configuration causesa substantially equal amount of suction to be provided at each of theapertures, which enhances the efficiency of the tissue aspirationprocess.

The apertures 72 may have a variety of shapes using the concepts of theinvention. In certain embodiments, the apertures 72 are round, oval,square or rectangular. Because of the limited space on the sides of thetip section, the area of the apertures 72 may be changed by varying alength of the apertures 72.

A distal end 76 of the tip section 68 is pointed, which enables thedistal end 76 to pierce the bone from which the tissue is to beharvested. In certain embodiments, the distal end 76 includes aplurality of sharpened surfaces, as illustrated in FIGS. 12 and 13. Thisconfiguration enhances the ability of the distal end 76 to penetratecortical bone from which the bone fragments and tissue are to beharvested. In certain embodiments, the distal end 76 includes about 10cutting flutes formed therein. Each of the flutes comes to a cuttingedge and such cutting edges provide the distal end 76 with a significantportion of its cutting ability. An aperture 78 may extend through thedistal end 76. The guide wire 54 is capable of extending through theaperture 78.

The tip section 68 also includes at least one cutting surface 80 on aside surface thereof. The at least one cutting surface 80 facilitatesmorselizing the tissue within the bone such that a greater percentage ofthe advantageous cells inside of the bone can be aspirated.

The at least one cutting surface 80 may comprise a plurality of cuttingedges that are generally oriented to extend parallel to the central axisof the needle portion 22. In certain embodiments, there are four cuttingedges, as illustrated in FIGS. 12 and 13.

The at least one cutting surface 80 may have a height that is no greaterthan the height of the main section 70. Using this configurationminimizes cutting of tissue as the needle portion 22 is inserted into orremoved from the patient.

At least part of the tip section 68 may have a generally planar surface84. In certain embodiments, there are four planar surfaces 84. Theplanar surfaces 84 may intersect proximate the cutting edges. The planarsurfaces 84 may provide a pathway for the bone fragments and morselizedtissue to flow to the apertures 72 during the aspiration process.

The at least one cutting surface 82 may also comprise at least oneabrasive region (not shown) on the outer surface of the tip section 68.The abrasive regions may be positioned between the cutting edges. Incertain embodiments, the abrasive regions are concentrated in proximityto the apertures 72.

In another embodiment, which is illustrated in FIGS. 14-16, the tipsection 68 includes a first tip region 130, a second tip region 132 anda third tip region 134. The first tip region 130 may be referred to asthe tissue cutting and/or disruption zone. The second tip region 132 maybe referred to as the aspiration zone. The third tip region 134 may bereferred to as the vacuum sealing zone.

The first tip region 130 is located proximate the distal end of the tipsection 68 and is the part of the tip section 68 that is primarilyresponsible for cutting tissue within the bone. The first tip region 130includes a plurality of cutting elements 136 formed therein. The cuttingelements 136 each have at least one cutting edge 138. In certainembodiments, the cutting elements 136 may be oriented to facilitatepreferential cutting when the needle portion 22 is rotated in aparticular direction. A portion of the cutting elements 136 may beoriented to facilitate preferential cutting in a clockwise direction anda portion of the cutting elements 136 may be oriented to facilitatepreferential cutting in a counterclockwise direction.

As used herein, preferential cutting refers to the surfaces of thecutting element 136 that form the cutting edge 138 forming an acuteangle. In certain embodiments, the angle between the two surfaces isbetween about 45 degrees and about 90 degrees. In other embodiments, theangle between the two surfaces is between about 60 degrees and about 80degrees.

In certain embodiments, there are four cutting elements 136. Two of thecutting elements 136 a are located proximate a first side 144 a of thefirst tip region 130 and two of the cutting elements 136 b are locatedproximate a second side 144 b of the first tip region 130. Providing thecutting elements 136 a, 136 b in this configuration not only facilitatessimilar cutting action while rotating the needle portion 22 in oppositedirections but also provides relatively open regions 148 a, 148 b on topand bottom surfaces 146 a, 146 b of the tip section 68 so that theaspiration process can cause the bone fragments and morselized tissue tobe drawn away from the cutting elements 136 for aspiration through theapertures 72.

At least one of the cutting elements 136 may have at least one cuttingtooth 142 formed therein. In certain embodiments, each of the cuttingelements 136 has a plurality of cutting teeth 142 formed therein. Thecutting teeth 142 may be located proximate the distal end of the tipsection 68 but are located in a spaced-apart orientation from the distalend of the tip section 68. This configuration minimizes the cuttingteeth 142 cutting tissue as the needle portion 22 is being inserted butrather facilitates preferential cutting with the cutting teeth 142 asthe needle portion 22 is rotated.

Each of the cutting teeth 142 may have a pointed distal end. The cuttingteeth 142 may be tapered between opposite ends thereof to facilitatepreferential cutting by the cutting teeth 142 in a similar direction asto the preferential cutting with the cutting element 136 to which thecutting teeth 142 are formed.

One of the cutting elements 136 a may be oriented to preferentially cutin the clockwise direction and one of the cutting elements 136 a may beoriented to preferentially cut in the counterclockwise direction.Similarly, one of the cutting elements 136 b may be oriented topreferentially cut in the clockwise direction and one of the cuttingelements 136 b may be oriented to preferentially cut in thecounterclockwise direction.

Similar to the embodiment illustrated in FIGS. 12 and 13, the aperture78 may extend through the distal end of the tip section 68. A primaryfunction of the aperture 78 is to allow the guide wire 54 to extendtherethrough when positioning the bone fragment and tissue harvestingdevice 12 with respect to the bone. A person of skill in the art willalso appreciate that the aperture 78 may permit the bone fragments andtissue to pass therethrough during the aspiration process.

The first tip region 130 may have a relatively short length compared tothe overall length of the needle portion 22. In certain embodiments, thefirst tip region 130 has a length of between about 5 millimeters andabout 20 millimeters. In other embodiments, the first tip region 130 hasa length of about 10 millimeters.

The first tip region 130 may have a generally circular outer profilethat tapers when moving towards the distal end of the tip section 68.The first tip region 130 may also taper when moving towards the secondtip region 132.

While it is desired for the first tip region 130 to have a relativelysmall diameter to minimize the hole that needs to be made in the outersurface of the bone, forming the first tip region 130 is a smalldiameter limits not only the rate at which the bone fragments and tissuecan be aspirated through the needle portion 22 but also raises thepotential that the bone fragments and tissue may plug the needle portion22. In certain embodiments, the first tip region 130 has a diameter ofbetween about 3 millimeters and about 10 millimeters. In otherembodiments, the first tip region 130 has a diameter of about 5millimeters.

The second tip region 132 has at least one aperture 72 formed in anouter surface thereof. In certain embodiments, the at least one aperture72 includes two apertures. One of the apertures 72 may be orientedproximate the upper surface of the tip section 68 and one of theapertures 72 may be oriented proximate the lower surface of the tipsection 68. This configuration causes the apertures 72 to be positionedin the opening between the cutting elements 136 and thereby enhances theability to aspirate the bone fragments and tissue that have been formedby the cutting elements 136.

In certain embodiments, the apertures 72 each have a generally circularshape. If it is desired to provide an enhanced ability to aspirate thebone fragments and tissue, the apertures 72 may be formed with anelongated shape similar to the aperture 72 illustrated in FIGS. 12 and13.

The second tip region 132 may have an outer surface that is smaller thanthe outer surface of the first tip region 130. This configurationfacilitates moving the bone fragments and morselized tissue from thecutting elements 136 to the apertures 72. While it is illustrated thatthe second tip region 132 has a generally cylindrical shape, a person ofskill in the art will appreciate that the second tip region 132 may havea variety of shapes that are capable of providing the precedingcharacteristics. In certain embodiments, the second tip region 132 hasan outer diameter of the second tip region 132 is about 4 millimeters.

The second tip region 132 may have a relatively short length. Thislength should be sufficiently long to facilitate moving the bonefragments and morselized tissue from the cutting elements 136 to theapertures 72. The length of the second tip region 132 may have a lengththat is less than the length of the first tip region 132. In certainembodiments, the second tip region 132 has a length that is betweenabout 3 millimeters and about 10 millimeters. In other embodiments, thesecond tip region 132 has a length that is between about 4 millimetersand about 5 millimeters.

Similar to the second tip region 132, the third tip region 134 may havea generally cylindrical shape to minimize cutting or disruption oftissue as the needle portion 22 is inserted into and removed from thebone as well as when the needle portion 22 is rotated. An outer diameterof the third tip region 134 is greater than the outer diameter of thesecond tip region 132.

Forming the third tip region 134 with the outer diameter that is greaterthan the outer diameter of the second tip region 132 causes the thirdtip region 134 to contact tissue adjacent thereto and form a sealbetween the third tip region 134 and the adjacent tissue to minimize thepotential of the vacuum to be pulled along the outer surface of thethird tip region 134 as opposed to causing the bone fragments andmorselized tissue to be aspirated.

In certain embodiments, the outer diameter of the third tip region 134is approximately the same as the outer diameter of the first tip region130. The third tip region 134 may have a diameter of between about 3millimeters and about 10 millimeters. In other embodiments, the thirdtip region 134 has a diameter of about 5 millimeters.

Alternative configurations for the tip section are illustrated in FIGS.17-20. The tip section embodiment illustrated in FIG. 16 includes agenerally cylindrical outer surface with a series of grooves formedtherein. The grooves are placed in a spaced-apart configuration and aregenerally transverse to an axis of the needle portion 22. The distal endof this embodiment has a plurality of flat sides that come to a point.

The tip section embodiment illustrated in FIG. 18 has an alternativegroove configuration from the tip section embodiment illustrated in FIG.16. The tip section embodiment illustrated in FIG. 19 includes a spiralgroove formed therein. The tip section embodiment illustrated in FIG. 20has two generally flat side surfaces in which apertures are formed.

A stop member 124 may be configured for removable attachment to theneedle portion 22 and having a configuration as illustrated in FIGS. 21and 22. In certain embodiments, the stop member 124 includes a firstgrip 150, a second grip 152 and a collar 154.

The first grip 150 and the second grip 152 both have an outer surfacethat is suitable for grasping by a person using the stop member 124. Anouter diameter of the first grip 150 and the second grip 152 is largerthan the diameter of the needle portion 22 to enhance the ability of theuser to grasp the first grip 150 and the second grip 152. Thisconfiguration also enhances the torque that can be applied whentightening the stop member 124 on the needle portion 22 and reduces thepotential of the stop member 124 inadvertently moving with respect tothe needle portion 22.

The first grip 150 includes a male threaded surface 151 that isengagable with a female threaded surface 153 on the second grip 152.Rotation of the first grip 150 with respect to the second grip 152thereby causes the first grip 150 to move towards the second grip 152.

The collar 154 may have a generally cylindrical configuration with aninner diameter that is slightly larger than an outer diameter of theneedle portion 22. At least a portion of the collar 154 is compressiblein response to a force placed upon the collar 154 such as when the firstgrip 150 and the second grip 152 are moved toward each other. Thecompressability of the collar 154 may be provided by a slot or keywaythat is formed in the collar 154.

The difference between the outer diameter of the stop member 124 and theouter diameter of the tip section 122 should be sufficiently large tolimit a distance that the tip section 122 can be inserted into the bone(ilium) but should not be considerably larger than the outer diameter ofthe tip section 122 to minimize trauma to the tissue proximate the boneas the tip section 122 is extended into the bone.

In an alternative embodiment, the stop member 124 may be fixedlyattached to the needle portion 22 such as illustrated in FIG. 11. In yetanother embodiment, a friction inducing object (not shown) is placedbetween the stop member and the needle portion 22. An example of onesuch friction inducing member is an O-ring. This configuration enablesthe user to push the stop member to a desired depth without having totighten any of the components.

In another embodiment, the bone fragment and tissue collection andprocessing device 14 includes an inlet port 50 that is connected to thebone fragment and tissue harvesting device 12 using the tubing 16. Thebone fragment and tissue collection and processing device 14 alsoincludes an outlet port 52 that is connected to a vacuum source (notshown) using tubing (not shown).

It may be desirable to separate non-liquid components in the bonefragment and tissue from liquid components in the bone fragment andtissue that are aspirated with the bone fragment and tissue harvestingdevice 12 because the non-liquid components may have advantageouscharacteristics when used in conjunction with bone glue prepared fromthe tissue. Examples of such non-liquid components include bone chipsthat are generated by the drilling process to access the interior of thebone. The non-liquid components may also include other tissue fromwithin the bone that is not completely morselized.

To collect the non-liquid components, filter media may be placed insideof the bone fragment and tissue collection and processing device 14while the tissue is harvested. In certain embodiments, the filter mediahas sufficiently large pores such that substantially all of liquid inthe aspirated tissue flows therethrough. However, the filter media hassufficiently small pores such that substantially all of the non-liquidcomponents in the tissue is retained on the filter media.

In one such embodiment, the filter media is placed proximate the openingin the collection vessel. The filter media may be retained in positionwith respect to the collection vessel using the collection vessel cap.

During the process of aspirating the bone fragments and tissue, thefilter media is placed in the bone fragment and tissue collectiondevice. Thereafter, once the aspiration process is complete, the filtermedia is removed from the bone fragment and tissue collection device.

The non-liquid components that were retained on the filter media may bemixed into the bone fragment and tissue after the red blood cells areseparated therefrom. Alternatively, the non-liquid components may bemixed with the bone graft material prior to the red blood cell depletedtissue being mixed with the bone graft material.

In one configuration, the guide wire 54 is positioned for location anddirection with respect to a bone from which the bone fragments andtissue are desired to be aspirated with the assistance of a fluoroscope.A drill bit is extended over the guide wire 54 and then used to drill ahole in the bone. The drill bit is withdrawn from over the guide wire 54and the guide wire 54 is extended into the aperture 78 until theproximal end of the guide wire 54 extends through the handle portion 20.

The distal end of the needle portion 22 is extended a short distanceinto the bone. The handle portion 20 is rotated in clockwise andcounterclockwise directions so that the tip section 68 causes tissueproximate thereto to be morselized. This process also causes bonefragments to be formed.

Thereafter, the user places his/her thumb over the suction controlmechanism 44 to cause the bone fragments and tissue proximate the tipsection to be aspirated. Because the beneficial cells in the tissuedecrease significantly as the tissue is aspirated, care is used to notaspirate too much of the tissue from a particular location.

The user's thumb is then removed from the suction control mechanism 44and then needle portion 22 is extended further into the bone. Thisfurther extension is between about 5 and 20 millimeters. The morselizingand aspiration process is repeated to cause an additional volume of bonefragments and tissue to be collected. This process is repeated until theneedle portion 22 is inserted a maximum distance into the bone or untilthe distal end of the needle portion 22 comes into contact with a hardbone surface.

At this time, the needle portion 22 is substantially withdrawn from thebone and then oriented in a different angular position. The insertion,morselizing and aspiration process is repeated until a desired amount ofthe bone fragments and tissue have been collected. This process enablesa greater volume of tissue to be recovered as compared to conventionalbone marrow harvesting processes. This process also enables a largervolume of tissue having advantageous cells to be collected.

In another embodiment in conjunction with aspirating bone fragments andmorselized tissue from a person's ilium 170, an incision is formedproximate the iliac crest. The distal end of the bone fragment andtissue harvesting device 12 is extended through tissue until adjacentthe ilium 170. A force is used to urge the distal end to pierce theilium 170. In certain embodiments, the force is provided by manualpressure.

The tip section 76 is extended into the ilium 170. In certainembodiments, the insertion is continued until the stop member 124contacts the surface of the ilium 170, as illustrated in FIG. 23. Sincethe tip section 76 is extended using manual force, the person using thetissue aspiration device 12 should readily feel the stop member 124contacting the surface of the ilium 170. The stop member 124 therebyoverly extending the tip section 76 into the ilium 170.

The handle portion 20 is used to cause the needle portion 22 to pivotwith respect to the ilium as illustrated in FIG. 24. The stop member 124thereby acts as a fulcrum. As the needle portion 22 is pivoted, the tipsection 76 moves through the tissue in the bone to thereby causeformation of bone fragments and morselizing of the tissue. Inparticular, this movement of the aspiration needle within the bonecauses communition of trabecular bone.

Care should be exercised when pivoting the needle portion 22 such thatthe force is discontinued when resistance is felt as such resistance canbe indicative of the tip section 76 contacting an inner surface of theilium 170 and further pivoting of the needle portion 22 could lead toexcessive bending of the needle portion 22 or damage to the ilium 170and/or damage of the bone fragment and tissue harvesting device 12.

Care should also be exercised when pivoting the needle portion 22 tominimize the force that is placed on the edge of the aperture in theilium 170 through which the tip section 76 extends as such force couldcause the size of the aperture to increase, which would impact theability of the stop member 124 to limit insertion of the needle portion22 into the ilium 170.

The pivoting of the needle portion 22 is continued until sufficient bonefragment and tissue morselizing within the bone are achieved. At suchtime, the vacuum control mechanism 44 is closed to cause the bonefragments and morselized tissue to be aspirated from within the ilium170. While the vacuum control mechanism 44 is closed, the needle portion22 can continue to be pivoted to increase the amount of the bonefragments and tissue that are aspirated from the ilium 170.

In certain bones that have a sufficient depth, it is possible topartially insert the needle portion 22 into the bone and then rotate toform bone fragments and morselize the tissue. The needle portion 22 isfurther inserted into the bone and then rotated. In an alternativeembodiment, it is possible to partially withdraw the tip section 76 fromthe ilium 170 and then repeat the pivoting and tissue aspiration. Once adesired amount of the bone fragments and tissue have been aspirated, theneedle portion 22 is withdrawn from inside of the patient.

This process can be repeated on different regions of the ilium toaspirate additional bone fragments and tissue. The process can also berepeated on the opposite side of the ilium. A person of skill in the artwill appreciate that the concepts described herein can also be used toaspirate bone fragment and tissue from other bones.

In the preceding detailed description, reference is made to theaccompanying drawings, which form a part hereof, and in which is shownby way of illustration specific embodiments in which the invention maybe practiced. In this regard, directional terminology, such as “top,”“bottom,” “front,” “back,” “leading,” “trailing,” etc., is used withreference to the orientation of the Figure(s) being described. Becausecomponents of embodiments can be positioned in a number of differentorientations, the directional terminology is used for purposes ofillustration and is in no way limiting. It is to be understood thatother embodiments may be utilized and structural or logical changes maybe made without departing from the scope of the present invention. Thepreceding detailed description, therefore, is not to be taken in alimiting sense, and the scope of the present invention is defined by theappended claims.

It is contemplated that features disclosed in this application, as wellas those described in the above applications incorporated by reference,can be mixed and matched to suit particular circumstances. Various othermodifications and changes will be apparent to those of ordinary skill.

The invention claimed is:
 1. A method of harvesting bone fragments andbone marrow comprising: providing a harvesting device comprising aneedle portion and a tip portion, wherein the needle portion has a boreformed therein, wherein the needle portion is fabricated from arelatively rigid material and wherein the tip portion is fixedly mountedto and extends from an end of the needle portion, wherein the tipportion comprises a first tip region, a second tip region and a thirdtip region, wherein the third tip region has at least one cuttingsurface and a recessed region proximate the at least one cuttingsurface, wherein the third tip region has an outer diameter, wherein thesecond tip region has an outer diameter that is less than the outerdiameter of the third tip region, wherein the recessed region extendsfrom a proximal end of the third tip region toward a distal end of thethird tip region so that the recessed region intersects the second tipregion, wherein the second tip region has at least one aperture formedtherein, wherein the at least one aperture intersects the bore, whereinthe first tip region has an outer diameter that is not smaller than theouter diameter of the third tip region, wherein the second tip region isintermediate the third tip region and the first tip region, wherein thesecond tip region extends proximally from the third tip region, whereinthe first tip region extends proximally from the second tip region andwherein the first tip region is not overlapping with the third tipregion and the second tip region; forming an aperture in a bone usingthe tip portion of the harvesting device, wherein a distal end of theneedle portion is fixedly attached to the tip portion such that theneedle portion extends proximally from a proximal end of the first tipregion and does not overlap any of the tip regions of the tip portion;inserting the tip portion and at least part of the needle portionthrough the aperture into the bone; rotating the harvesting device whilethe at least part of the needle portion is inserted into the bone sothat the tip portion causes the bone fragments to be formed and the bonemarrow to be morselized inside the bone to enhance the ability toaspirate the bone marrow to aspirated; forming a direct seal between thefirst tip region and tissue proximate the aperture to substantiallyprevent vacuum to be pulled between the first tip region and the tissueproximate the aperture; and applying a vacuum to a proximal end of thebore to cause the formed bone fragments and the morselized bone marrowto move through the recessed region, from the third tip region into thesecond tip region, through the at least one aperture and into the boreto be aspirated from the bone, wherein because the needle portion isfabricated from the relatively rigid material, the needle portionresists bending and/or deformation along its length while being rotatedinto the aperture in the bone and while the bone fragments and bonemarrow are aspirated from the bone.
 2. The method of claim 1, whereininserting at least part of the needle portion, rotating the harvestingdevice and applying a vacuum are done at the same time.
 3. The method ofclaim 1, wherein the at least one cutting surface comprises a firstcutting surface and a second cutting surface and wherein the recessedregion is between the first cutting surface and the second cuttingsurface.
 4. The method of claim 1, wherein the at least one cuttingsurface comprises a first cutting surface and a second cutting surface,wherein the method further comprises: rotating the needle portion in afirst direction in which the first cutting surface preferentially cuts;and rotating the needle portion in a second direction in which thesecond cutting surface preferentially cuts, wherein the first directionis opposite the second direction.
 5. The method of claim 1, and furthercomprising: partially withdrawing the needle portion; pivoting theneedle portion with respect to the bone; and inserting the needleportion into the bone.